Dicks don't do well on drugs. We've talked about this before, but for a number of reasons – mostly because stimulants like MDMA and cocaine work as vasoconstrictors, restricting blood-flow – they are liable to make your penis shrink an almost inconceivable amount.
If you are a man who has taken those drugs, you will know this, because you'll have witnessed it firsthand. Problem is, cocaine also makes a lot of people who take it – some of them men – want to have sex. Which is not ideal, or, in fact, feasible whatsoever when your dick is the size of an acorn.
"A recent study found that, in humans, cocaine administration increased sexual desire, but decreased condom usage," explains Mary Samplaski MD, a director of the male fertility section at the Institute of Urology, University of Southern California. "And while every man is different, for many men cocaine will result in sexual dysfunction."
"Cocaine may lead to ejaculatory difficulties and lower ejaculatory volumes," Dr Mandy Tozer, Medical Director at CARE Fertility London, tells me. "Chronic use of cocaine may lead to priapism, which is a persistent painful erection often needing medical assistance – it's a serious condition that can cause permanent damage to the penis."
To summarise so far: cocaine locks you in an unbearable state in which you desperately want to have sex, but can't, because you can't get it up; makes you less likely to use a condom if you do eventually manage to (so higher risk of STDs); then, unsheathed, you're left thrusting endlessly because you're unable to orgasm. Bonus point: once you've done enough coke you might get a boner so solid and so persistent that it hospitalises you. Cherry on top: greatly reduced sperm count.
Dr Tozer says it has been shown that the use of cocaine is more common in men with lower sperm counts, and that chronic use of cocaine can reduce sperm counts. That's before you factor in the fact that cocaine is often used alongside alcohol and, if you're a smoker, or even a "can I pinch a fag, I only smoke when I'm fucked" smoker, cigarettes – both of which are known to have detrimental effects on sperm.
Samplaski adds, "One study looking at the effects of cocaine on testicular histology and function found that cocaine produced a rapid disruption of sperm production, approximately declining by half. Cocaine administration also resulted in lowered testosterone levels, and it has been shown to result in sperm death, an effect that may be related to its effects on constricting blood flow."
Maybe when I'm 35 and not still eating Domino's as a form of self-care, I might actually want to have children. What if, against the odds, I manage it?
"There is insufficient information regarding the potential for cocaine use in men to cause birth defects," says Dr Tozer. "But it has been shown that, in mice, sperm may act as a vector to transport cocaine into an egg."
Let us sit, for a moment, with the fact that sperm could potentially carry cocaine into eggs.
Not great, especially when – according to Samplaski – studies have shown that "babies born to mums using cocaine while pregnant had significant neurologic and developmental abnormalities". At one year old, she adds, children had significantly lower cognitive and motor scores. So although proper scientific tests have not been established – partly, as Mary tells me, due to "patient fear about disclosing their use because [cocaine] is an illegal drug" – it would seem that coke can possibly travel from sperm to egg, thereby impacting the child before it's even born.
So, I'm freaking out now. I'm guessing maybe you are too. In the UK, cocaine hospitalisations are up, the number of cocaine-related deaths is rising, cocaine purity is way up and use is increasing year on year, partly because – for a fifth of users – it's quicker to get a bag delivered than a pizza. What effect all this will have on fertility clinic patronage in the near future, only time will tell.